Chest
Original ResearchCOPDCough and Sputum Production Are Associated With Frequent Exacerbations and Hospitalizations in COPD Subjects
Section snippets
Study Design
A cross-sectional analysis of a cohort of COPD patients recruited between January 2005 and May 2007 was performed. The subjects were recruited from 17 pulmonary units in university hospitals located throughout France. Respiratory physicians prospectively recruited subjects with a secured diagnosis of COPD who were in stable condition (ie, no history of exacerbation requiring medical treatment for the previous 4 weeks). The diagnosis of COPD was based on the presence of a postbronchodilator FEV1
Description of the Study Cohort
Data were collected on 502 subjects; 23 subjects were excluded from the analyses because spirometry results showed a postbronchodilator FEV1/FVC > 70% (former GOLD stage 0). Additionally, 46 subjects were excluded from the analyses because the presence or absence of chronic cough and sputum production had not been recorded accurately. These 46 subjects were not statistically different from the other subjects for age, gender, smoking habits, FEV1, or exacerbations (data not shown). Thus, the
Discussion
Studying a large cohort of COPD subjects, we found that the number of exacerbations during the previous year was the only independent factor linked to chronic cough and sputum production. In addition, chronic cough and sputum production were associated with frequent exacerbations, including moderate and severe exacerbations. Importantly, the association between chronic cough and sputum production and frequent exacerbations was independent of other known risk factors for frequent exacerbations,14
Conclusions
Our data suggest that chronic cough and sputum production are closely associated with the occurrence of COPD exacerbations, including severe exacerbations. Interestingly, longitudinal studies16, 27 have shown that chronic cough and sputum production may not be a stable feature. Although current therapies are not known to affect chronic cough and sputum production, we suggest that therapeutic interventions targeting chronic cough and sputum production may be useful. Because frequent COPD
Appendix
The members of the Initiatives Bronchopneumopathie Chronique Obstructive (BPCO) Scientific Committee are as follows: Graziella Brinchault-Rabin (Rennes); Pierre-Régis Burgel (Paris, Cochin); Denis Caillaud (Clermont-Ferrand); Philippe Carré (Carcassonne); Pascal Chanez and Christophe Pinet (Marseille); Ari Chaouat (Vandoeuvre les Nancy); Isabelle Court-Fortune (Saint-Etienne); Antoine Cuvelier (Rouen); Roger Escamilla (Toulouse); Chantal Raherison (Bordeaux); Christophe Gut-Robert and
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Cited by (0)
This work was funded by unrestricted grants from Boehringer Ingelheim France and Pfizer.
The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).
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A list of members of the Initiatives Bronchopneumopathie Chronique Obstructive (BPCO) Scientific Committee is located in the Appendix.